REPORTS TO: Chief Medical Officer
LOCATION: Washington, D.C.
The Senior Manager of Quality Programs guides ACHP’s clinical performance improvement strategy that drives member organizations’ understanding of the care they provide for their communities. This individual researches and designs innovation programs for quality improvement and care management, strongly supported by quantitative analysis. The analysis and insights allow ACHP member plans to clearly understand and communicate the value of the care they provide and stay among the top rated health plans in the nation. The senior manager is a self-starter who collaborates closely with health plan clinical executives and quality leaders to develop learning programs around quality performance in all lines of business. The senior manager also builds strong relationships with health care quality stakeholders and organizations such as NCQA, positioning ACHP as a thought leader on quality measurement and performance. Successful candidates will employ a knowledge of quality measurement and health plan operations, experience with making meaning out of data, as well as an ability to facilitate adult learning environments.
This individual should be passionate about high-quality, affordable care and be an idea-generator who can help ACHP and its members further these goals. The senior manager position reports to the Chief Medical Officer and is a key member of the Clinical Innovation team. We are a small organization and place a high priority on enthusiastic team members who are eager to grow.
CORE DUTIES AND RESPONSIBILITIES
- Use knowledge of plan and provider operations in combination with data analyses to develop learning and innovation programs for quality leaders and clinical executives to improve ACHP health plan performance.
- Work collaboratively to develop presentations that clearly and concisely convey quality improvement opportunities and insights for key internal and external audiences.
- Assist ACHP’s integrated Advocacy team in communicating quality performance to policymakers, thought leaders and journalists, advancing perspectives on public reporting and quality rating systems.
- Build close relationships with ACHP members through ongoing engagement with senior health plan leaders to identify critical issues affecting performance.
- Manage member work groups in the areas of CMS MA Star Ratings, NCQA Accreditation and HEDIS reporting, clinical analytics as well as newly identified clinically-oriented topics of interest.
- Serve as a proactive liaison to the health care measurement community, including NCQA, PQA, and NQF, to foster meaningful engagement on behalf of ACHP health plans
- Contribute as a key writer for ACHP’s internal and external reports on clinical programs and innovations (e.g., PCORI research report)
- Develop innovative thinking and ideas around the future of quality measurement.
PROFESSIONAL EXPERIENCE, EDUCATION AND OTHER QUALIFICATIONS
- Bachelor’s degree required; Graduate degree in health-related field strongly preferred. Clinical background and experience a plus.
- 7+ years of relevant work and leadership experience with deep knowledge and experience with health plan quality ratings and measurement, including HEDIS, CAHPS and CMS Medicare Advantage Star Ratings.
- Understanding of health plan clinical operations; experience working at a health plan a plus.
- Strong writing skills; experience with grant writing or management a plus.
- Ability to make the connections between health care policy and real-world business dynamics.
- Excellent judgment and critical thinking skills.
- Confident and friendly verbal communication with a customer-focused mindset.
- Project management skills and demonstrated attention to detail with strong organizational abilities.
Please submit a resume and cover letter via e-mail to ACHP Human Resources at firstname.lastname@example.org. Your cover letter must include your salary requirements. Please include Senior Manager, Quality Programs, along with your first initial and last name in the subject line of your e-mail message.
Making Health Care Better
The Alliance of Community Health Plans is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. Our plans are shaping the future of health care - driving better health outcomes, building healthier communities and inspiring an entire industry to do better.